Congenital diaphragmatic hernia repair analysis in relation to postoperative abdominal compartment syndrome and delayed abdominal closure

Costa, Karina Miura da; Saxena, Amulya K.

doi:10.1007/s13304-021-00980-1

Cited by 5 publications

(2 citation statements)

References 19 publications

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“…The study emphasizes the fact that the optimal mode of IAP measurement in children remains unclear, especially in neonates. [ 32 ]…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Surgical Outcomes in Neonates with Left-sided Congenital Diaphragmatic Hernia with Only Skin Closure versus Abdominal Muscle Closure

Vutukuru,

Menon,

Solanki

2024

Journal of Indian Association of Pediatric Surgeons

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Aim: This study aims to compare the outcome of neonatal left congenital diaphragmatic hernia (CDH, Bochdalek type) repair through laparotomy with and without abdominal muscle closure. Materials and Methods: This retrospective study was conducted between January 2012 and May 2021 at a neonatal surgical unit of a Tertiary Care Center. Demographic details, preoperative management, Two-dimensional-echo, intra-operative findings, postoperative course, and follow-up data were collected and analyzed. Results: The study group comprised 50 neonates with a mean standard deviation (SD) age at admission: 4.44 (5.12) days, male: female ratio of 3:2, and mean (SD) weight: 2.73 (0.51) kg. Following repair of the diaphragmatic defect through laparotomy, 26 (52%) underwent skin closure alone, whereas 24 (48%) underwent abdominal muscle closure. Postoperatively, there was a significant fall in the level of platelets (P = 0.021), increase in pressure support by at least 4–5 cm H2O (P = 0.027), and increase in the blood urea (P < 0.001), creatinine (P = 0.005), lactate (P = 0.019), and acidosis (P = 0.048) in the muscle closure group. Although not statistically significant, there was a fall in the urine output and blood pressure in this group. There was no significant difference in the duration of inotropes. Mortality was 8 (32%) in the skin closure group, and 14 (61%) in the muscle closure group (P = 0.05). Conclusions: Neonates undergoing left CDH repair through the abdominal route with skin closure alone, had better survival, as well as hematological, renal, and ventilatory parameters than those who underwent muscle closure. It is a useful surgical modification to improve outcome in centers with limited facilities.

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“…The study emphasizes the fact that the optimal mode of IAP measurement in children remains unclear, especially in neonates. [ 32 ]…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Surgical Outcomes in Neonates with Left-sided Congenital Diaphragmatic Hernia with Only Skin Closure versus Abdominal Muscle Closure

Vutukuru,

Menon,

Solanki

2024

Journal of Indian Association of Pediatric Surgeons

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“…The use of appropriate mesh, resection of intestines to lessen the volume of the abdominal organs, and delayed abdominal closure are measures to decrease the risk of ACS. ACS after repair of CDH in neonates is frequently reported [ 24 ]. Delayed abdominal closure with the use of silicone silo bags or vacuum-assisted closure devices is performed to prevent ACS in neonates with a large volume of herniated content and limited abdominal capacity.…”

Section: Discussionmentioning

confidence: 99%

Right-sided Bochdalek hernia in an adult with hepatic malformation and intestinal malrotation

et al. 2021

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Background Bochdalek hernia is a common congenital diaphragmatic defect that usually manifests with cardiopulmonary insufficiency in neonates. It is very rare in adults, and symptomatic cases are mostly left-sided. Diaphragmatic defects generally warrant immediate surgical intervention to reduce the risk of incarceration or strangulation of the displaced viscera. Case presentation A 47-year-old woman presented with dyspnea on exertion. Computed tomography revealed that a large part of the intestinal loop with superior mesenteric vessels and the right kidney were displaced into the right thoracic cavity. Preoperative three-dimensional (3D) simulation software visualized detailed anatomy of displaced viscera and the precise location and size of the diaphragmatic defect. She underwent elective surgery after concomitant pulmonary hypertension was stabilized preoperatively. The laparotomic approach was adopted. Malformation of the liver and the presence of intestinal malrotation were confirmed during the operation. The distal part of the duodenum, jejunum, ileum, colon, and right kidney were reduced into the abdominal cavity consecutively. A large-sized oval defect was closed with monofilament polypropylene mesh. No complications occurred postoperatively. Conclusion Symptomatic right-sided Bochdalek hernia in adults is exceedingly rare and is frequently accompanied by various visceral anomalies. Accurate diagnosis and appropriate surgical repair are crucial to prevent possible incarceration or strangulation. The preoperative 3D simulation provided comprehensive information on anatomy and concomitant anomalies and helped surgeons plan the operation meticulously and perform procedures safely.

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Reasons for conversions in thoracoscopic repairs of neonatal congenital diaphragmatic hernias: a systematic review

da Costa,

Stratulat,

Saxena

2024

Surg Endosc

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Congenital diaphragmatic hernia repair analysis in relation to postoperative abdominal compartment syndrome and delayed abdominal closure

Cited by 5 publications

References 19 publications

Comparison of the Surgical Outcomes in Neonates with Left-sided Congenital Diaphragmatic Hernia with Only Skin Closure versus Abdominal Muscle Closure

Comparison of the Surgical Outcomes in Neonates with Left-sided Congenital Diaphragmatic Hernia with Only Skin Closure versus Abdominal Muscle Closure

Right-sided Bochdalek hernia in an adult with hepatic malformation and intestinal malrotation

Reasons for conversions in thoracoscopic repairs of neonatal congenital diaphragmatic hernias: a systematic review

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